Screening questionnaires to identify problem drinking in the primary care setting: a systematic review

Aim Guidance on screening instruments is lacking. Early recognition of harmful drinking patterns is of socio-economic importance for health policies. Aim of this systematic review was to investigate the validity and reliability of alcohol screening questionnaires to identify problem drinking as a secondary prevention measure. Subject and methods About eight million people live in Austria and approximately 360,000 are diagnosed with chronic alcoholism. In 2011, the direct medical cost for alcohol-related diseases was 374 million Euros. The hazardous effects of excessive drinking and the problems caused by alcohol are frequently documented. A systematic search of the literature was conducted in online databases between September and December 2014. Inclusion criteria included the use of alcohol-screening instrument compared to a gold standard, primary care setting, and adults over 18 years. Results Eight diagnostic accuracy studies and three systematic reviews were included in this review. The reviewed scientific literature demonstrates the validation of five alcohol-screening instruments plus their abbreviated versions that are currently available in German-speaking countries. Those instruments are suitable for primary care depending on the validated setting. Conclusion Primary healthcare workers do not routinely screen for harmful drinking in their usual practice in German-speaking countries. Brief interventions are initiated based on results of screening tests; hence, the opportunity for brief interventions is missed. However, guidance and training on validated alcohol-screening instruments and information on the content of brief interventions is currently missing in German-speaking countries.